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Pathology/Lab Coding Alert

CPT® 2015:
87505-87507: Check Out New GI Pathogen Detection Codes
Capture multiple targets with one code. If your lab performs one of the new commercial... Read more
CCI 20.3:
Overlook Semen Analysis Bundles at Your Peril
Choose just one code for most complete procedure. The last quarterly Correct Coding In... Read more
Medicare Rules:
Break the Modifier 59 Habit in 2015
Get more specific with 4 new X{EPSU}modifier options. If your lab or pathology practic... Read more
Expect Direct Crosswalk for Procreative and Sterilization Testing
Primary diagnosis ban continues. Virtually nothing changes except the code numbers whe... Read more
Reader Question:
Choose Thin-Prep Pap Codes by Screening Technique
Question: I’m trying to select the proper code for the thin-prep Pap tests th... Read more
Reader Question:
Consider Modifier for Follow-Up Calcium
Question: Our lab performed a basic metabolic panel with total calcium, and the phy... Read more
Reader Question:
Sharing Private Health Information -- Know the Physician's Place
Question: Our pathologist wants to talk to an oncologist about a patient’s co... Read more
You Be the Coder:
Don't Wander from LCIS ICD-9 Choice
Question: The pathology report on a breast case states, “lobular carcinoma in... Read more
CPT® 2015:
Revamp Your IHC and ISH Reporting With 2015 'Makeover'
Look for parallel construction to simplify coding. After a year of dealing with contra... Read more
Answer 'Where?' for Adenomatous Colon Polyps
You’ll need more info in 2015. When your pathologist diagnoses an adenomatous... Read more
Advance Beneficiary Notice:
Dispel 4 Lab ABN Myths With These Tips
Learn how to use the ‘courtesy’ modifier. Your lab often faces this hurdle... Read more
Medicare Incentives:
Avoid Pay Cuts with PQRS
Deadlines rush your lab clients to EHR, too. With more than enough pay cuts to go arou... Read more
Reader Question:
Distinguish Serologic Type and Screen
Question: If the lab performs a “type and screen” for a blood transfusi... Read more
Reader Question:
Zero In on Hip Fracture Exam Code
Question: A pathologist in our office believes that we can’t classify a hip f... Read more
You Be the Coder:
Metatarsal Amputation -- Foot or Toe?
Question: When our pathologist examines a transmetatarsal amputation specimen, do y... Read more
CPT® 2015:
Prepare for Nearly 90 New, Revised, or Deleted Lab Codes
You’ll need to learn yet another IHC-stain paradigm shift. Forewarned is forearm... Read more
187.8 Scatters in Diagnosis Code-Set Transition
Distinguish penis, other male genital organs for overlapping sites. You won’t fi... Read more
Clip and Save:
Get Familiar With CPT® 2015 Lab and Pathology Code Changes
Save this handy chart for future reference throughout the coming year. An overview can... Read more
Follow 3 Tips to Seize Opportunities and Face Demands for Your Lab
Stick with HIPAA, CLIA, HITECH direction. It’s a wonder that anyone can keep up ... Read more
Reader Question:
Method, CLIA Rules Lead Code Choice
Question: Our lab performs urine drug testing by dipstick for multiple drugs as par... Read more
Reader Question:
88305 Encompasses Biopsy
Question: If the pathologist receives a specimen labeled “breast excisional b... Read more
Reader Question:
Meet Qualifications for Specific Codes
Question: Our lab has a gynecologist client who is trying to charge 88141 for inter... Read more
You Be the Coder:
Check These Diagnoses for Pathologic Femur Fracture
Question: Our pathologist examined a femur neck specimen with a fracture from the p... Read more
CCI 20.2:
Beware IHC Bundles for Medicare
Recap CCI Policy Manual explanations. Unlike in some past years, you won’t get o... Read more
Order HER2/neu For Breast Cancer With This Code
Learn crosswalk from ICD-9. Sometimes your pathologist gets a request for HER2/neu imm... Read more
CPT® 2015:
Expect Drug Testing Overhaul Next Year
Learn presumptive and definitive categories. If you’re like many lab coders who ... Read more
Follow 3 Tips to Capture Repeat Pap Test Pay
Reason for repeat is key. Coding for Pap tests is complicated enough, but coding for r... Read more
Reader Question:
Code Final Diagnosis
Question: We received an excision specimen labeled “left thumb mass.” T... Read more
Reader Question:
Select Glucose Code by Method
Question: We’re getting denials when we bill a blood glucose test with 82962.... Read more
Reader Question:
Look for Pathologic Fracture Detail in ICD-10
Question: When the pathologist diagnoses a pathologic fracture in the femur seconda... Read more
You Be the Coder:
Don't Let 'Container' Fool You
Question: The pathologist received a single specimen container with tissue identifi... Read more
Case Study:
Don't Lose $218 for This Prolapsed Uterus With Fibroids
Use final diagnosis to snag additional pay. You may think that coding the pathology ex... Read more
See How Your Hospital Lab Can Bill TC for Non-Hospital Patients
You can choose who bills the payer. Question: When is a hospital lab an independent la... Read more
Learn D25 Vocabulary to Broaden Uterine Fibroid Dx
Look for a direct crosswalk with more specific descriptions. You won’t have b... Read more
Lab Modifiers:
Make Payer Rules Your Bottom Line for 59, 91, 76, and More
Don’t rely on definitions alone. You can parse the CPT® modifier descriptors... Read more
Reader Question:
Follow Payer for Drug Test Code Choice
Question: The lab performs a drug screen using a cup method, then performs a confir... Read more
Reader Question:
Don't Use 88342 for All Negative HER-2/neu
Question: Our lab performs a HER-2/neu antibody test on paraffin embedded breast ti... Read more
Reader Question:
Show the Secondary Diagnosis for Hepatitis Screen
Question: A physician client requested a hepatitis screening test for a patient wit... Read more
You Be the Coder:
Count Specimens for Medicare Prostate Biopsy Codes
Question: The pathologist received and examined six prostate biopsy specimens. Shou... Read more
Dominate Infectious Agent Antigen Coding With These 5 Tips
Reporting 87260-87902 just got easier. Only a couple of small changes infected the CPT... Read more
CPT® 2014:
1 Code + 1 Phrase = Microbiology Changes You Need to Know
Reverse transcription not required. Now that you’ve refreshed your memory on how... Read more
Hierarchy Scrambles Hepatitis C Codes
Acute/chronic distinction will lead in ICD-10. You’ll have the same number of co... Read more
Surgical Pathology:
Know When to 'Unbundle' Thyroidectomy
Don’t lose $71 that your pathologist deserves. Here’s something that doesn... Read more
ICD-10 Implementation:
Check Out This CMS Update
ICD-9 update in question, too. You might have more questions than answers about the IC... Read more
Reader Question:
Avoid 'Insufficient' Diagnosis Terminology
Question: For an FNA evaluation, the pathologist wrote a final diagnosis of “... Read more
Reader Question:
Check 3 Rs for Interpretation
Question: When our lab performs a serum protein electhrophoresis and quantifies the... Read more
Reader Question:
Distinguish Wet Mount, Other Vaginal Tests
Question: The lab receives a vaginal fluid specimen for an “amines” tes... Read more
Reader Question:
Immunohistochemistry Depends on Method
Question: The lab report states, “progesterone receptor negative: 0 staining ... Read more
You Be the Coder:
Choose FISH as PhD or MD Service
Question: If we perform FISH aneuploidy +13, +18, +21, X, Y for a paraffin-embedded... Read more
Case Study:
Hone Your Bone Coding With This Report
88304-88309 hold the keys. Selecting a surgical pathology code might seem straightforw... Read more
88160-88162: Finally Master These Niche Specimen Codes
Avoid the 5-slide trap. Here’s a code that baffles many new pathology coders, an... Read more
Diagnosis Update:
733.11 Crosswalks to 85 Code Choices in ICD-10
Remember 7th digit for encounter. How much more can you say about a disease-related... Read more
Protecting Access to Medicare Act of 2014:
Watch the New Direction that CLFS Repricing Takes
Law impact on labs is more than ICD-10 delay. You’ve heard the frenzy over the I... Read more
Reader Question:
Master HCPIN in ICD-9, ICD-10
Question: I find prostate diagnoses very confusing, with PIN III and CIS and other ... Read more
Reader Question:
Do This for Repeat Lab Test
Question: A physician ordered an electrolyte panel for a 72-year-old female patient... Read more
Reader Question:
Zero In on Coombs Test for Obstetric Panel
Question: We perform the obstetrics panel except that we perform an indirect Coombs... Read more
Reader Question:
Capture Separate Ovarian Pathology
Question: Our pathologist received a uterus/tubes/ovaries specimen in which he diag... Read more
You Be the Coder:
Method, Payer, CLIA Rules Lead Code Choice
Question: Our lab performs urine drug testing by dipstick for multiple drugs as par... Read more
Morphometric Analysis:
Avoid 5 IHC Pitfalls and Get Home by 6
Counting and computers are key. Don’t spend all day trying to get your quantitat... Read more
Sidestep CCI Edits for Smooth IHC Sailing
Watch for common bundles you need to know. Now that you’ve learned how to &ldquo... Read more
Straddle Lymphoid Cancer Classification
Don’t let name changes confuse you You’ll have a direct crosswalk for B-ce... Read more
Breast Case:
To Bundle or Not to Bundle: That is the $288 Question
Focus on specimen to make the ‘margin’ call. Everyone’s scared of &l... Read more
Implementation Delay:
You Have At Least 1 More Year for ICD-10 Prep
Don’t fall into theprocrastination trap. “The Secretary of Health and Huma... Read more
News You Can Use:
Medicare Pay Cut Averted
Payment stays level through March 31, 2015. Remember the threat of a drastic pay cut f... Read more
Reader Questions:
Make Sure Stain is 'Special'
Question: Our pathologist went to the surgical suite and performed an FNA adequacy ... Read more
Reader Question:
Block Versus Specimen for ISH
Question: We run HPV sub-typing for high-risk and low-risk strains on two blocks fr... Read more
You Be the Coder:
Distinguish Vaginal Tissue Codes
Question: Our pathologist examined tissue from a vaginal mesh removal and reported ... Read more
Pap Testing:
Hone Your Skills With This Screening-Turned-Diagnostic Pap Case
Don’t miss HPV opportunity. With 15 CPT® codes and 10 HPCS Level II codes fo... Read more
Look for HPV Changes on October 1
Low risk gets its own code. When your lab reports positive results for human papilloma... Read more
Clinical Lab Tests:
Thought You Could Never Charge for Calculations? Think Again
Just be careful not to double bill. You’ve heard it said that you can never bill... Read more
For the Record:
7 Characteristics Embody Good Documentation
Make sure your pathologist has the tools. Your coding skills might be top notch, but y... Read more
Reader Question:
Focus on Transplant Suitability
Question: How should we code if we perform HLA typing for multiple A and B antigens for ... Read more
Reader Question:
Don't Lose UA Pay
Question: If we do a urinalysis (UA) dipstick test in the office lab and find an abnorma... Read more
Reader Question:
Beware Skin Upcoding
Question: Our pathologist examined a large (13 cm x 6 cm) skin excision from a patient&r... Read more
Reader Question:
Distinguish NOS, NEC
Question: What is the difference between NEC and NOS in the ICD-9 manual, and will I nee... Read more
You Be the Coder:
Check FOBT Coverage Rules
Question: We’re receiving denials for three-card fecal hemoccult screening tests t... Read more
CCI 20.0:
Don't Double Dip with 'Method' Codes
Molecular pathology includes every step. Each January, you can expect new Correct Coding ... Read more
Medicare Payment:
G0461, G0462 Capture Qualitative IHC
Distinguish rules for 88342, +88343. The CPT® 2014 promise of billing immunohistoc... Read more
Z17.0-Z17.1 Mirror ER Status Reporting
Expect direct crosswalk with new code set. Only the numbers and letters will change fo... Read more
Quantitative/Semiquantitative IHC:
88360-88361 Use 'Specimen' as Unit of Service
Only 88342 allows ‘per block.’ Problem: The same immunohistochemistry (IHC... Read more
Medicare Payments:
Get Answers to CF, SGR, Sequestration Pay Questions
Define your 2014 pathology pay expectations. CMS settled several payment questions as ... Read more
Reader Question:
Check CLIA List for Waived Tests
Question: If we’re performing 85610 and 80061 in a physician-office lab, should we... Read more
Reader Question:
Simple Collection Included
Question: Is there a CPT® code for swabbing a wound to collect fluid to send to a la... Read more
Reader Question:
Don't Use 52 for Lab Equipment Failure
Question: We’ve always reported Pap tests to one payer with 88174, but now they&rs... Read more
Reader Question:
88104 Describes Abscess Drainage Exam
Question: We received drainage from a lymph node abscess. The pathologist examined a dir... Read more
You Be the Coder:
Capture Consult and Special Stains
Question: When we receive a tissue block for consultation and prepare additional H&E... Read more
MPFS 2014:
20.1 Percent Cut Awaits Act of Congress
Proposal for cap at OPPS levels tabled — for now. Your anatomic pathology practi... Read more
Prepare to Change Your Prostate Biopsy Exam Coding
Surprise definition change in MPFS could cost your practice plenty. Out of the blue, t... Read more
ICD-10 Preparedness:
Get Ready to Test Your Lab
Mark your calendars for March testing week. Maybe you’ve done your preparation a... Read more
CLFS 2014:
Watch Out for 'Revaluation' and 'Bundling'
Payment levels net little change. Pricing isn’t the only thing you need to look ... Read more
Reader Question:
Appeal, Don't Resend, Denied Claims
Question: If we know that the Medicare contractor has made a mistake in denying one of o... Read more
Reader Question:
Revert to Ordering Diagnosis
Question: Our pathologist recently examined a prostate biopsy specimen for a patient who... Read more
Reader Question:
Clarification: See Who Can Bill for Arterial Puncture
Question: I read in your newsletter Vol. 14 No. 11 “Don’t Confuse Blood Draw... Read more
Reader Question:
Bill Culture Despite no Growth
Question: We are performing a cytogenetic analysis on a bone marrow specimen, and after ... Read more
Reader Question:
Pick Specific Organism Code
Question: We can’t find a “not otherwise specified” code for infectiou... Read more
You Be the Coder:
Neoplasm Drives Ovary/Tube Specimen
Question: What is the correct procedure code for right salpingo-oophorectomy with a diag... Read more
CPT® 2014:
81057, 87661: These Codes May Have Ob/Gyn Clients Calling
Fetal evaluations and STD infection diagnosis at stake. You might see more lab test or... Read more
Trichomoniasis Boasts Direct Crosswalk
Organism and infection site focus codes. Coding urogenital Trichomonas infections won&... Read more
CPT® 2014:
10 Reasons to Update Therapeutic Drug Assay Codes
See what you can expect for payment, too. When physicians order quantitative assays fo... Read more
Modifier Update:
Avoid Pitfalls of 59 Overuse
Look to 91 or 76 in some cases. Rumor has it that Medicare no longer accepts modifier ... Read more
Reader Question:
Distinguish Surgery from Pathology Procedure
Question:Our pathologist examined a “shave biopsy,” and when I spoke to the ... Read more
Reader Question:
Modifier PT is Out for Pathology
Question: We billed 88305 and 88342 with modifier PT for a diagnosis of V76.51 and 211.3... Read more
Reader Question:
Whooping Cough Test Code is in the Details
Question: Due to increased number of whooping cough cases, we’re starting to perfo... Read more
Reader Question:
Distinguish Cyst, Neoplasm
Question: What are the correct diagnosis and procedure codes for a hair follicle excisio... Read more
You Be the Coder:
Capture Polarizing Microscopy Service
Question: The pathologist examined a bursa fluid aspirate smear from the left elbow, ide... Read more